Dry and Secondary Drowning: What Parents Need to Know

A study of near-drowning cases suggests roughly 5% of children who have had serious drowning scares go on to encounter secondary drowning.

Whether you plan to hit your local water park, stroll for seashells, ride waves at the beach, or soak up some sun at the pool, summer is the time to do it. Across the country, families are busy planning their final weeks of summer before the kids return to school. Water fun has all the ingredients of a good time and sunny escape, but it is important that parents always stay alert when enjoying family time at the beach, pool, or lake. With so many opportunities for water play and swimming, child drowning can peak in the summer months. According to the Centers for Disease Control and Prevention, two children die from drowning each day. Preschoolers ages 1-4 have the highest drowning rates, and drowning is the second leading cause of death after motor vehicle accidents for children 14 and under.

As parents, we all want to protect our children from harm. Family and caregivers can play a huge role in minimizing risk of drowning by teaching children how to swim, closely supervising them in the water, and learning life-saving skills like CPR. However, it is difficult to manage risk when one is unaware of a potential threat. It goes against common sense and logic to think that a person can drown even after they are out of the water, yet, that is just the case. In addition to conventional drowning, children who have had near-drowning experiences in the water are still at risk for drowning many hours later. This very rare, but potentially deadly condition, is referred to as “dry drowning” or “secondary drowning.”

Dry drowning occurs when a child breathes in small amounts of water while struggling to stay afloat in the water and the larynx and vocal cords spasm from the change in temperature when the cold water hits the throat. The spasms in the airway muscles prevent the water from going into the child's lungs, but they also prevent air from entering the lungs, too, making it very difficult to breathe and necessitating medical intervention.

Secondary drowning occurs when a child breathes in water while trying to stay afloat, and the water actually enters and irritates the lungs. Additional fluid produced in the lungs to deal with the irritation caused by ingested water collects, causing pulmonary edema and makes breathing challenging. If left untreated, pulmonary edema can lead to cardiac arrest.

Preschoolers ages 1-4 have the highest drowning rates, and drowning is the second leading cause of death after motor vehicle accidents for children 14 and under.

Dry and secondary drowning can be hard to identify and treat, as the child may appear to be alright in the immediate aftermath of a near drowning. A recent case in San Diego, California, raised public awareness to the danger of secondary drowning. In a blog post that went viral, Lindsay Kujawa bravely shared the frightening story of her 2-year-old son's near drowning in an effort to help other parents. Kujawa's toddler, Ronin, was underwater for about 20 seconds at a family pool party. Although he appeared to recover, Kujawa was concerned about the changes in behavior she observed in her son later that day, particularly a strange, persistent cough and extreme lethargy.

In what would be a life-saving course of action, she called her pediatrician, who advised her to take Ronin to the emergency room immediately. Ronin received chest X-rays and blood tests and was diagnosed with chemical pneumonitis from ingestion of the pool water. Fortunately, with medical intervention, Ronin's story has a happy ending: he survived and is now a joyful, healthy little boy.

Kujawa's sharp analysis of Ronin's changes in behavior following the incident and her decision to seek medical care literally saved her son's life. Her decision to share her story, no matter how vulnerable it made her feel, may also save many more children's lives.

“I hope this brings awareness to all who read this,” Kujawa writes in her blog, Delighted Mama. “I am so thankful that Ronin is OK and that I decided not to put him to bed that night thinking everything was fine. I have said many, many thank-you prayers over the past few days for that. I want to make sure this never happens to another child, so pass this on and please share with those who you think might need to know.”

As Ronin's story illustrates, the symptoms of secondary drowning might be more subtle and understated than you would imagine. Here are some signs and symptoms to look for that indicate your child may be a victim of dry or secondary drowning:

Dry and secondary drowning can be treated with oxygen or ventilation at the hospital. However, time is a critically important factor in the effectiveness of treatment. It is imperative not to wait and monitor your child at home, but trust your instinct and seek immediate emergency medical care. Children who are asthmatic or have bronchial problems especially need to receive quick and comprehensive emergency medical care.

It is imperative not to wait and monitor your child at home, but trust your instinct and seek immediate emergency medical care.

Prevention/Water Safety

In terms of preventative measures, experts say parents can reduce the risk of dry drowning by teaching children to keep their mouths closed when jumping or diving into cold water, which is less likely to trigger muscle spasm in the airway (laryngospasm.) Children with cardiac or respiratory issues may also benefit from entering cold water gradually rather than instantly. Several measures may also be taken to create an environment less conducive to secondary drowning. Parents or caregivers should closely supervise inexperienced swimmers and remind them to “blow water out.” Adults interacting with children in the water should avoid dunking or unexpectedly throwing them into the water because it puts them at greater risk for ingesting water. At any large gathering of friends or family where there is swimming, a designated adult should be appointed lifeguard in addition to parental supervision.

It is important to have knowledge of dry and secondary drowning and accurate medical information regarding it, but parents should not let fear of drowning prevent them from enjoying quality time with their kids at a swimming pool, lake, beach, or water park. Incidents of dry and secondary drowning are relatively rare. There are some inconsistencies in how health care providers and agencies track the numbers, and some do not distinguish between different types of drowning in their data collection. However, they all agree incidents of dry and secondary drowning are low. A study of near-drowning cases suggests roughly 5% of children who have had serious drowning scares go on to encounter secondary drowning.

In Our Hearts

EverydayFamily extends deepest sympathies to families who have lost a child to drowning. We're very thankful little Ronin is fully recovered and well, and we extend appreciation and admiration to his brave mama, Lindsay, for sharing his story in an effort to help save other children's lives, too.

EverydayFamily.com offers general information and is for educational purposes only. This information is not a substitute for professional medical, psychiatric or psychological advice. Nothing on this website should be taken to imply an endorsement of EverydayFamily.com or its partners by any person quoted or mentioned.

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